What Expenses Are Eligible Under a Health Spending Account?
Learn which health costs qualify for tax-free reimbursement under CRA rules
Health Spending Accounts (HSAs) in Canada offer a flexible and tax-efficient way to cover a wide range of medical and dental expenses. But not every cost qualifies. Eligible expenses are based on the Canada Revenue Agency’s (CRA) list of allowable medical expenses, which means your HSA must follow those guidelines to preserve its tax-free status.
Understanding what is covered, and what is not, helps you plan care, avoid surprises, and get the most value from your HSA.
Common Eligible Expenses
Most health-related services and supplies that would qualify for the Medical Expense Tax Credit are also eligible for reimbursement through an HSA. These include:
| Category | Examples of Eligible Expenses |
|---|---|
| Medical services | Doctor visits, diagnostic tests, surgery, medical specialists |
| Dental care | Cleanings, fillings, root canals, orthodontics |
| Vision care | Eye exams, prescription glasses, contact lenses, laser surgery |
| Prescription drugs | Medications prescribed by a licensed medical practitioner |
| Paramedical services | Chiropractors, physiotherapists, massage therapists, acupuncturists |
| Mental health services | Psychologists, psychotherapists, clinical counsellors |
| Mobility and aids | Crutches, hearing aids, orthopedic shoes, medical braces |
| Fertility and family | Fertility treatments, prenatal care, breast pumps |
These expenses are reimbursed using pre-tax dollars from your HSA, allowing you to reduce your out-of-pocket costs more efficiently than if you claimed them on your personal tax return.
Less Obvious Eligible Items
Beyond the basics, HSAs can also cover:
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Smoking cessation programs and prescription aids
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Diabetes supplies like test strips and monitors
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Nutritional counselling by a registered dietitian
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Travel expenses related to medical care (e.g. mileage, accommodations)
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Medical marijuana (if legally prescribed and sourced)
Tip: Keep all receipts and prescriptions, even for smaller or less common services. Many people miss out on reimbursement simply because they are unsure whether something qualifies.
What Is Not Covered
Some items may feel health-related but do not qualify under CRA rules. These include:
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Over-the-counter medications or vitamins without a prescription
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Cosmetic procedures like teeth whitening or Botox
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Gym memberships, spa treatments, or massage chairs
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Non-prescription eyeglasses or cosmetic contact lenses
Caution: Submitting ineligible expenses could lead to claims being denied and, in some cases, may affect the tax status of your HSA if audited. Always check your provider’s list or confirm with the CRA before submitting a new type of claim.
How to Stay Organized and Maximize Your Claims
To get the most out of your HSA:
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Track your spending throughout the year, not just at tax time
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Set reminders to submit claims before your plan’s annual deadline
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Check if your plan allows roll-over of unused amounts to the next year
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Review your claims history to identify recurring out-of-pocket costs that could be shifted into the HSA
A Personalized, Tax-Friendly Approach to Health Care
Eligible expenses under an HSA are broader than most workplace benefit plans and can be tailored to your family’s specific needs. From braces and therapy to travel and prescription care, this tool gives you the flexibility to decide how your health dollars are spent — all while saving on taxes and paperwork.